Twelve people have died and 4,089 others have taken ill since the hepatitis outbreak in the first week of May in the town

Pune: The hepatitis E virus infection has been detected in more than 95% of the blood samples taken from 80 people in Ichalkaranji in Kolhapur district. The samples were tested by scientists at the Pune–based National Institute of Virology (NIV).

Twelve people have died and 4,089 others have taken ill since the hepatitis outbreak in the first week of May in this textile town of western Maharashtra.

"Only three or four of the 80 serum samples tested negative. This confirms it is an outbreak of the hepatitis E virus. No dual infection was seen in this outbreak. Some of the water samples taken from supply points in the town were found to have fecal contamination,"scientist Vidya Arankalle, senior deputy director and head, hepatitis division, NIV, said here on Friday.

"Though the disease is usually self-limiting, it can lead to fulminant liver failure, which is associated with high mortality. We want to find out the probable cause of this severity in people carrying the hepatitis E infection. In the case of this infection, a higher proportionate mortality has been described in pregnant women," Arankalle said.

Hepatitis is an infection of the liver caused by the virus. "Of the four main types of the virus, hepatitis A and E are waterborne while hepatitis B and C infection comes through infected blood or sexual transmission," said gastro–enterologist Harshal Gadhikar of Deenanath Mangeshkar Hospital. NIV tests 80 blood samples, finds most hepatitis E infected

Although the clinical picture is similar and the type of virus can only be confirmed by laboratory tests, there are differences in the mode of transmission, incubation period, long-term complications and mortality rates.

"The incubation period of the hepatitis E virus ranges from six days to six weeks depending on individual immunity. Therefore, despite being infected with the virus, a person with good immunity may remain unsymptomatic (without illness) for days together. The infection can cause illness between six days and six weeks depending upon one’s immunity. That’s why we are continuously seeing cases even after initiating high chlorination water purification methods," officials from the state health department said.

Ichalkaranji, which has a population of 3 lakh, receives 80 per cent of its water supply from the Krishna river and the remaining from the Panchganga river. Supply from the Krishna was totally stopped due to repair and maintenance work in April. The town had to make do with water from the Panchganga, which is a highly polluted river.

The water from the Panchganga needs high chlorination to make it fit for consumption. It is believed that the same amount of chlorination that was used to purify water from the less polluted Krishna was used to purify the Panchganga waters. This is suspected to have caused the hepatitis E virus outbreak. It is also suspected that the water got mixed with drainage water due to leakages in the supply system.

Untreated sewage is released into the Panchganga, making it highly polluted. Kolhapur city alone discharges over 65 MLD (million litres daily) of sewage into the river, affecting 60 villages and Ichalkaranji town, which are downstream.

Meanwhile, patients from the town have been admitted to the Indira Gandhi Memorial Hospital, Chhatrapati Pramilaraje Rugnalaya and D Y Patil Hospital, besides several other hospitals in Ichalkaranji and Kolhapur.

In 2005, a similar outbreak occurred in Baramati in which the hepatitis virus infected around 2,500 people and claimed six lives. "This outbreak in Ichalkaranji is even more explosive than the one in Baramati," state health department officials said.

Meanwhile, 49 cases of the hepatitis E virus infection have been reported from village Pathpanhala in Kolhapur district, some 55 km from Ichalkaranji, and another 26 cases in village Takawade, just 3 km from the textile town. "There is no death in either village so far. We are closely monitoring the situation," the officials said.